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This is the 18th year Fortune has ranked the Most Powerful Women in business outside the U.S. GlaxoSmithKline CEO Emma Walmsley takes the top spot this year, ending the four-year reign of Banco Santander Executive Chair Ana Botin. The 50 global businesswomen here represent 19 countries and a variety of industries.
By Erika Fry, Carson Kessler, Ellen McGirt, McKenna Moore, Polina Marinova, and Claire Zillman. Click here for our methodology.

Emma Walmsley

CEO, GlaxoSmithKline, 49

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Courtesy of GlaxoSmithKline

Walmsley has held the top job at GSK, the $38.9 billion British pharma firm, for 17 months, and she has been quick in bringing change to the 300-year old company. In March, she purchased Novartis’s 36% stake in GSK Consumer Health, the joint venture the two firms formed in 2014 and which, as one of the world’s largest OTC businesses, did $9.4 billion in sales last year. In July, she did a $300 million deal with 23andMe, the data-rich direct-to-consumer genetic testing company, to collaborate on drug development. She’s hired a high profile roster of talent from across the industry and beyond—poaching executives from AstraZeneca, Novartis, Pfizer, Walmart and HSBC among others—and putting them to work on her No. 1 agenda item: reinvigorating drug development at the company.